Monday, 1 August 2011

Diabetic Neuropathy

The recent estimate puts the number of people suffering from diabetes in the US at 26 million, with almost a quarter of them not yet knowing that they have diabetes. Simply put, diabetes is a disease characterized by poor control of blood glucose levels in the body. Of the many complications of diabetes mellitus, the one we would focus here is Diabetic Neuropathy.

So what is diabetic neuropathy and what problems will a patient suffering from diabetes will have if he develops neuropathy? Simply put, diabetic neuropathy in most cases refers to the damage to nerves due to prolonged diabetes. The patient having diabetic neuropathy may have numbness, tingling and pins-and-needles sensations.

Another common problem that comes with loss of sensations in the lower limbs is results in causing non healing ulcers in the feet, which may be infected, sometime severe enough to need amputation to save a person's life. Some people may have a different presentation with pain as main feature, and the pain may be in form of mild burning or aching sensation to sometimes very severe. Later even weakness and wasting of muscles may develop and patients may have foot drop or wrist drop in diabetes. Sometimes diabetic neuropathy affects nerves responsible for movements of eyes. More diverse symptoms ranging from mild ones like increased heart rate, difficulty in swallowing food, diarrhea, constipation and involuntary leakage of urine to more severe problems like impotence, ejaculation into bladder, sudden hypotension on standing from lying down or sitting position and even sudden cardiac death may occur.

What makes Diabetic Neuropathy more worrisome is that there are not many satisfactory treatment options that provide immediate relief available at this time. Prescribed diet and exercises along with medications or insulin or both to control blood glucose levels should be religiously followed but they have little or sometimes no role in reversing the damage to nerves that have already happened. Only reversible forms are the one that involve single nerves (mononeuropathies) or nerve roots.

People suffering from diabetic neuropathy should not smoke or drink alcohol as these neurotoxins and may worsen the neuropathy. They should also take vitamin supplementation (B12 and folate). People should also check their foot daily for any calluses or ulcers and preferably wear special foot wears designed for diabetes patients. In cases of long-standing painful neuropathy, some medications are often found to be effective. Other treatment options mainly focus on the symptoms due to neuropathy like sudden fall in blood pressure on standing up is managed by using support stockings, adequate salt intake, avoiding dehydration and some drugs if necessary. Some newer treatment options in form of new drugs may be effective in some of the patients. Thus the control of blood glucose levels in diabetes to prevent neuropathy is of paramount importance.

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